Card 18 / 34: A 75 year-old woman has had regular daily bowel movements throughout her entire life. She comes to your office because she has noted a marked change in her bowel habits. She now will only have a bowel movement every third day and the stool is hard and difficult to pass. She has recently been taking a morphine derivative due to back pain. She has no known neurologic disorder and leads a very active life style. A colonoscopy is normal. Which of the following most likely has caused her symptoms of constipation?
1.) Irritable bowel syndrome
2.) Colonic pseudoobstruction
3.) Inadequate fiber intake
4.) Narcotic use
5.) Large rectocele

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